Posterior Interosseous Nerve Syndrome: Diagnosis and Surgical Management. A Case Report

Bello Figuim, Nchufor Ndouh Roland, Sini Victor, Maggy Mbede, Vincent Djientcheu

Abstract


RÉSUMÉ
Radial nerve compression at the elbow is rare and has variable clinical presentations. Compression of the deep motor branch at the arcade of Frohse constitutes a rare syndrome and could have diverse etiologies. It leads to paralysis of finger and wrist extensors. We report the case of a 20 years old male who consulted for weakness in the extensor muscles of the right hand that had been evolving slowly over 8 years without sensory involvement. On electromyogram, compression of the radial nerve at the radial tunnel was suspected and the exact location was determined with echography to be at the arcade of Frohse. The patient was then operated upon and the recovery of motor functions post-op was satisfactory.

ABSTRACT
La compression du nerf radial au niveau du coude est peu fréquente et son expression clinique est variable.  L’atteinte de la branche profonde motrice au niveau de l’arcade de Frohse est un syndrome rare et les étiologies sont diverses. Elle est responsable de la paralysie des extenseurs des doigts et du carpe. Nous rapportons le cas d’un patient de 20 ans venu consulter pour faiblesse des extenseurs de la main droite évoluant depuis huit ans sans atteinte sensitive. L’électromyogramme a suspecté une compression au niveau de la gouttière radiale et l’échographie a précisé le site de compression au niveau de l’arcade de Frohse. Le patient a été opéré et la récupération motrice était satisfaisante.

Keywords


radial nerve compression, arcade of Frohse syndrom

Full Text:

PDF

References


- Latinovic, R., M. C. Gulliford, and R. A. Hughes.. Incidence of common ompressive neuropathies in primary care. J. Neurol.Neurosurg.Psychiatry 2006 ; 77:263–265.

- Frohse F, Fränkel M. Die muskeln des menschlichen armes. In: Bardeleben K, editor. Handbuch der anatomie des menschen.Jena: Gustav Fischer; 1908:164–165

- Dang AC, Rodner CM. Unusual Compression Neuropathies of the Forearm, Part I: Radial Nerve. The Journal of Hand Surgery. 2009; 34:1906–1914. [PubMed: 19969199]

- Spinner M. The arcade of Frohse and its relationship to posterior interosseous nerve paralysis. The Journal of Bone and Joint Surgery. 1968; 50B: 809–812.

- Guitlain G, Courtellemont (1905) L'action du muscle court supinateur dans la paralysie

du nerf radial. Presse Med 1905 ;13: 50-52

- Lubahn JD, Cermak MB. Uncommon nerve compression syndromes of the upper extremity. J Amer Acad Orthop Surg. 1998 Nov-Dec; 6(6):378-386.

- Roles NC, Maudsley RH. Radial tunnel syndrome: resistant tennis elbow as a nerve entrapment. J Bone Joint Surg Br 1972;54(3):499-508.

- Cravens G, Kline DG. Posterior interosseous nerve palsies. Neurosurgery 1990;27:397-402

- Debouck C, Rooze M. The arcade of Frohse : an anatomic study. Surg Radiol Anat (1995)17 : 245-248

- Boudine L, Mahdadi S, Boukabache L, Benleghrib N. L’arcade de Frôhse et la compression du nerf radial au coude : une approche morphométrique. Morphologie 2017;101(335): 218. doi.org/10.1016/j.morpho.2017.07.141

- Babaei Ghazani R, Roomizadeh P, Sanaei G, Najarzadeh Mehdikhani S, Habibi K, Nikmanzar S, Kheyrollah Y. Ultrasonographic reference values for the deep branch of the radial nerve at the arcade of Frohse. Journal of Ultrasound (2018) 21:225–231

https://doi.org/10.1007/s40477-018-0303-8

- YD Wininger, NA Buckalew, R A. Kaufmann, MC Munin. Ultrasound combined with electrodiagnosis improves lesion localization and outcome in posterior interosseous neuropathy. Muscle Nerve. 2015 December ; 52(6): 1117–1121. doi:10.1002/mus.24782.

- Ong C, Nallamshetty HS, Nazarian LN, Rekant MS, Mandel S. Sonographic diagnosis of posterior interosseous nerve entrapment syndrome Radiology Case Reports. 2007;2:67.

- Raimbeau G Compressions du nerf radial au coude Radial nerve compression at the elbow Chirurgie de la main 23 (2004) S86–S101

- Omura T, Nagano A, Murata H, Takahashi M, Ogihara H, Omura K. Simultaneous anterior and posterior interosseous nerve paralysis with several hourglass-like fasicular constrictions in both nerves. J Hand Surg [Am]. 2001 Nov;26(6):1088-92.

- Lawley AR, Shouvik Saha S, Manfredonia F. Posterior interosseous neuropathy: the diagnostic benefits of a multimodal approach to investigation. Clinical Case Reports 2016; 4(4): 437–441


Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution 3.0 License.

********************************************************************************************